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Chlamydia infection in males

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Male genitourinary system

Definition
Chlamydia is a sexually transmitted disease, or STD, caused by the organism Chlamydia trachomatis. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. In men, the infection normally involves the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. Chlamydia is one of the most common sexually transmitted infections in Australia, yet it is one of the most invisible.

What is going on in the body?
The organism Chlamydia trachomatis causes chlamydia infection. It infects the cells and causes a number of changes. The organism is usually passed from one partner to another during sexual intercourse. Irritation and inflammation of the man's urethra from the infection often causes symptoms. Other areas of the body, including the rectum and the throat, can also become infected with chlamydia.

What are the signs and symptoms of the infection?
Sometimes, a chlamydia infection of the urethra has no symptoms. When present, symptoms may include the following:
  • watery or mucous-like discharge from the penis
  • burning or pain with urination
  • having to urinate frequently
Chlamydia infections of the throat usually cause a sore throat.

Following are symptoms that can be caused by chlamydia infections of the rectum:
  • rectal pain
  • discharge from the rectum, which may be bloody
  • frequent, painful urges to have a bowel movement
What are the causes and risks of the infection?
The organism that causes a chlamydia infection is usually passed from one partner to another during sexual intercourse. Any other intimate contact of the genitals, mouth, rectal area, or the sharing of sexual toys can transmit the organism from one individual to another.

A man's risk of chlamydia infection is increased if he has more than one sexual partner.

What can be done to prevent the infection?
Several safer sex practices can help prevent the spread of chlamydia infection. Male condoms and female condoms provide some protection. Single partner relationships are safer than sexual interaction with multiple partners.

Any new partners should be asked about their sexual history and should be tested for sexually transmitted disease. Sexual contact should be postponed until the tests show no infection in the partner.

How is the infection diagnosed?
A doctor will suspect chlamydia if a man has watery discharge from the penis or a burning sensation when urinating. Symptoms of rectal pain and rectal discharge frequently are symptoms of chlamydia in those who have anal sex.

A complete examination of the appropriate area is done to look for discharge and other infections. A cotton swab is often used to take a sample of any discharge present. If no discharge is seen, a cotton swab may be used to swab the inside of the urethra, rectum, or throat. The swab is then sent to the laboratory for testing. This can help determine whether there is an infection, and if so, which organisms are causing it.

What are the long-term effects of the infection?
Chlamydia infection can cause acute epididymitis, or inflammation of a structure attached to the testes. Rectal chlamydia can cause narrowing of the rectum or ulcers in the rectum.

What are the risks to others?
If a chlamydia infection is not treated, a man can pass it to any sexual partner. This is true even if he does not have symptoms. Chlamydia infections in females can lead to cancer of the cervix, infertility, and ectopic pregnancy. An ectopic pregnancy is one in which the fertilised egg implants outside the uterus.

What are the treatments for the infection?
Taking antibiotics usually cures the infection. Normal healing may still leave some scar tissue. Sexual partners should also be treated. Sometimes a combination of antibiotics is used for 7 to 10 days. Antibiotics commonly used to treat chlamydia infections include azithromycin, doxycycline and erythromycin. Azithromycin is taken as a single dose as opposed to doxycycline which is taken over some ten days.

What are the side effects of the treatments?
Antibiotics may cause stomach upset, rash, or allergic reactions.

What happens after treatment for the infection?
It may take days or weeks for symptoms to go away. This is true even when treatment is successful. Sometimes, an individual can quickly become infected again if his or her sexual partner has not been treated at the same time. In some cases, chlamydia infections do not clear up. This can be due to organisms that are resistant to antibiotics.

How is the infection monitored?
After a course of antibiotics has been taken successfully, the doctor may repeat the culture of material from the infected area. If the test is positive, it usually means re-infection has occurred. This is particularly likely if a sexual partner has not been treated or did not complete treatment.

Being screened for chlamydia every year, or any time there is a new sexual partner, is a good practice. Any new or worsening symptoms should be reported to the doctor.

Author:
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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